Differences in Rural vs Urban Healthcare

While 20% of Americans live in rural areas, only 9% of America’s doctors practice there. Oddly enough though, patients of urban physicians often have longer wait-times.

So which medical environment is better? Rural or urban?

Though there’s an urge to discover whether people in cities or the countryside have it better when it comes to access to medical professionals, statistical differences between states and the way people in both areas use healthcare make a definitive winner-loser comparison impossible.

What we can do is look at a few telling aspects of how rural medical care compares to that of cities:

The bad news

Lower household income to pay for healthcare
The average household income in rural areas is generally less than in cities. When it comes to healthcare, that means fewer people can afford coverage in the first place. (source)

The good news

Knowing this, country doctors are often much more aware of the problem on an individual basis and are more willing and flexible to work with patients to come up with payment plans they can handle.

The bad news

Fewer people in the country seek out medical aid
Sometimes due to cost, sometimes due to good ol’ fashioned country stubbornness (“I haven’t needed a doctor yet and I don’t need one now”), fewer people in rural areas seek medical attention when they need it…in some cases, up to 11% fewer people than in urban areas. (source)

The good news

Doctors in the country really want to be your doctor
The doctors who do work in rural communities tend to be general practitioners instead of specialists, They are more interested in making a difference in the community than getting the highest pay, and tend to stay in the community longer than doctors stay at an urban practice.

The bad news

Higher insurance rates in the country
Less competition among insurance companies in rural areas and fewer employers who have healthcare plans (a larger percentage of rural residents are self-employed) means that in many states, it will cost you more (up to 25% more) to get insured in the country than in the city. (source)

The good news

More attention, faster
Because there are many more people in rural areas who need medical treatment but do not seek it out, those who do have medical coverage have shorter wait times for seeing a doctor and get more of a doctor’s time than those in urban areas. Also, many rural doctors still make house calls: Especially important for communities that don’t have 911 service.

The bad news

People in rural areas aren’t confident they will be able to get the care they need
A May 2000 study by the Urban Institute found that – for the most part – people in rural areas were less confident than people in cities that they would be able to get necessary medical care when they needed it. In Washington state, the percentage of people in rural communities who weren’t confident they could get treatment was double that of people in cities. (source)

The good news

Doctors in the country learn more hands-on
A rural posting allows a medical professional to be a big fish in a small pond, often being the lead in unique circumstances. This forces them to look up information on specific conditions and enriches their knowledge and experience. In small communities, doctors or interns may often get chances to practice which their urban counterparts may have to wait months to experience. (source)

In many ways, the image of the ol’fashioned country doctor is alive and well in rural America.

Both doctors and patients still want this image to continue, and in many ways, it makes sense.

Rural healthcare’s best asset is the care rural doctors provide to existing patients, Where it falls down by the numbers is in the shrinking number of people who can afford (or perceive they can afford) to become patients of those doctors.

I do agree with the point that doctors in rural areas tend to be more well-rounded when it comes to primary care. It is not uncommon to see a family practice doctor in rural areas treating peds through geriatric, helping out with OB, covering the ER on weekends and handling inpatient rounds at the rural hospital. They become very confident in their skills and knowledge base partly out of necessity. They are more apt to consult with other docs even counties away when they run into something that stumps them.

Great article. Interesting note about the amount of people living in rural areas vs. the doctors. 72 million Americans live in rural areas regardless of which is best (urban or rural) both need attention!

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